Heel Bursitis: Symptoms, Causes, Diagnosis & Treatment

Written by Medicover Team and Medically Reviewed by Dr S K Madhava Rao Nekkanti , Orthopedics

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Heel bursitis is a painful condition caused by inflammation of the bursa, a small fluid-filled sac that cushions the tissues around the heel. It commonly develops due to repetitive stress, improper footwear, injury, or overuse. Symptoms include heel pain, swelling, tenderness, and discomfort while walking or standing. Early diagnosis and appropriate treatment help reduce inflammation, relieve pain, restore mobility, and prevent recurrence.

What Are the Types of Heel Bursitis?

Heel bursitis is classified based on the location of the inflamed bursa.

Retrocalcaneal Bursitis: Inflammation of the bursa located between the Achilles tendon and the heel bone.
Superficial Calcaneal Bursitis: Inflammation of the bursa located between the skin and the Achilles tendon, often caused by pressure from footwear.

What Are the Symptoms of Heel Bursitis?

The symptoms of heel bursitis usually develop gradually and may worsen with prolonged standing, walking, or exercise.

Pain at the back or underside of the heel
Swelling around the heel
Tenderness when touching the affected area
Redness and warmth over the heel
Pain that worsens during walking, running, or climbing stairs
Difficulty wearing shoes due to heel discomfort
Stiffness around the Achilles tendon, especially after rest
Reduced range of motion of the ankle in severe cases

What Are the Causes of Heel Bursitis?

Heel bursitis can result from various factors, ranging from biomechanical issues to environmental conditions. The following outlines some of the common causes:

Repetitive Stress and Overuse: Engaging in repetitive activities, such as running or jumping, places considerable stress on the heel. Over time, this can lead to inflammation of the bursa. Athletes, particularly runners and basketball players, are at heightened risk due to the constant pounding their heels endure.
Improper Footwear: Wearing shoes that do not provide adequate support or that excessively rub against the heel can contribute to bursitis. High heels, in particular, can exacerbate the condition by placing additional stress on the heel and altering the body's natural alignment.
Trauma or Injury: Direct blows or impacts to the heel can cause the bursa to become inflamed. Such trauma might occur from an accident, fall, or sports-related injury.
Underlying Health Conditions: Certain health issues, such as arthritis or gout, can predispose individuals to bursitis. These conditions often involve inflammation of the joints, which can extend to the bursae, including those in the heel.

When to See a Doctor for Heel Bursitis?

Consult an orthopedics or podiatrist if heel pain persists for more than a few days, worsens despite home care, or interferes with walking. Early treatment can help prevent chronic pain and improve mobility.

You should see a doctor if you have:

Persistent heel pain or swelling
Difficulty walking or bearing weight
Redness and warmth around the heel
Symptoms that do not improve with rest and ice

Get medical help immediately if:

Severe heel pain after an injury
High fever with redness and swelling of the heel
Pus or drainage from the affected area
Inability to walk or bear weight on the foot

These could indicate an infection or a serious injury requiring urgent medical care.

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How is Heel Bursitis Diagnosed?

Accurate diagnosis of heel bursitis involves a combination of medical history evaluation, physical examination, and imaging tests.

Medical History and Physical Examination

A healthcare provider will inquire about the onset, duration, and nature of the pain, as well as any activities that exacerbate or alleviate symptoms. A physical examination will assess the range of motion, tenderness, and swelling in the heel.

Imaging Tests

X-rays, ultrasounds, or MRIs may be utilized to rule out other conditions, such as fractures or plantar fasciitis. These imaging tests provide a detailed view of the heel's structures, aiding in confirming the presence of bursitis.

What Are the Treatment Options for Heel Bursitis?

Treatment for heel bursitis aims to reduce inflammation, alleviate pain, and prevent future occurrences. Depending on the severity, treatments may include:

Conservative Treatments

Rest and Ice: Reducing activity and applying ice packs to the affected area can help minimize swelling and pain.
Footwear Modifications: Switching to shoes with proper support and cushioning can significantly reduce stress on the heel.
Orthotics: Custom orthotics or heel cups may be recommended to provide additional support and relieve pressure.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective in reducing pain and inflammation. In some cases, corticosteroid injections may be administered to provide rapid relief.

Physical Therapy for Heel Bursitis

Physical therapy plays a vital role in the treatment plan, focusing on strengthening the muscles around the heel, improving flexibility, and correcting biomechanical issues. Therapists may employ techniques such as stretching exercises, ultrasound therapy, and manual manipulation.

Surgical Intervention

In rare cases where conservative treatments fail, surgical removal of the inflamed bursa may be considered. This is typically a last resort, reserved for severe, persistent cases of bursitis.

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How can Heel Bursitis be Prevented?

Prevention of heel bursitis centers around minimizing risk factors and adopting healthy lifestyle practices:

Proper Footwear: Invest in shoes that offer good arch support and cushioning.
Gradual Activity Increase: When starting a new exercise regimen, gradually increase intensity to avoid overstressing the heels.
Regular Stretching: Incorporate stretching exercises into your routine to maintain flexibility and reduce tension on the heel.

What Is the Recovery Process for Heel Bursitis?

Most people recover within a few weeks with appropriate treatment. Following rehabilitation exercises and preventing excessive strain on the heel can reduce the risk of recurrence.

Rest the affected foot until symptoms improve
Perform stretching and strengthening exercises as recommended
Wear supportive, well-fitting footwear
Use orthotics or heel cushions if advised
Gradually return to physical activities
Maintain a healthy body weight to reduce heel stress
Attend follow-up appointments if symptoms persist or recur

Frequently Asked Questions

1. What are the symptoms of heel bursitis?

Symptoms of heel bursitis include pain at the back of the heel, swelling, tenderness, and stiffness, particularly when walking or standing for extended periods.

2. What causes heel bursitis?

Heel bursitis is primarily caused by repetitive stress on the heel, injury, or conditions like arthritis or gout that can lead to inflammation of the bursa, the fluid-filled sac cushioning the heel joint.

3. What are the risk factors for heel bursitis?

Risk factors include overuse from sports or occupations involving repetitive heel movements, obesity, and certain foot conditions like flat feet or high arches.

4. How is heel bursitis diagnosed?

Diagnosis typically involves a physical exam, review of symptoms, and sometimes imaging tests like X-rays or MRI to rule out other conditions.

5. What treatment options are available for heel bursitis?

Treatment may include rest, ice, anti-inflammatory medications, and physical therapy to strengthen the heel and reduce inflammation. In severe cases, corticosteroid injections may be considered.